叙事医学反思性写作对共同决策价值探析

以叙事医学工具反思性写作为切入点,首先从医方、患方及外部环境三个角度分析了当前医患共同决策所面临的临床实践困境,其次在对反思性写作概念、实践特点概述的基础上,提出了叙事能力对临床工作的重要性、叙事医学伦理对决策困境的作用,最后从促使医方自我反思,避免引导式决策及权威主义;弥合医患视阈差异,达成决策共识;阐明并澄清患者偏好及价值观,促进个体化共同决策;提高患者参与决策意愿,调动参与决策积极性;缓和医患关系,实现医患共情,促进共同决策良性互动五个方面阐述了反思性写作对医患共同决策困境的助力作用。

     

低阶层者的系统合理化水平更高吗?——基于社会认知视角的考察

系统合理化理论曾提出,低阶层者比高阶层者具有更高的系统合理化水平,即更认可社会体系的合理性、更支持当前社会系统。但这一论断一直存在争议。研究引入社会认知视角,考察低阶层与高阶层者系统合理化水平的差异及其机制。两个分研究得到了共同的结果:(1)低阶层者的系统合理化水平显著低于高阶层者;(2)这一差异是通过贫富归因的中介作用实现的,低阶层者系统合理化水平较低是基于其更少地认为社会贫富差距是由个人内部因素所致;(3)这一中介作用会受到个体控制感水平的调节,当控制感较低时,上述中介作用成立;但当控制感较高时,低阶层会弥合与高阶层贫富归因的差异,中介模型不成立。这些结果支持并发展了系统合理化的认知途径解释和阶层社会认知理论这两个立足于社会认知的理论观点,显示了认知因素在此问题中的重要作用,构建了更整合的阶层—归因—合理化的逻辑,并考虑了其边界因素,对于了解低阶层者的社会心态及其形成机制,包括如何改变此状况,均有一定的现实启示意义。     

Efficacy of self-administered treatments for pathological academic worry: A randomized controlled trial

Research on treatments for reducing pathological worry is limited. In particular, academic worry is a common theme in generalized anxiety disorder (GAD) samples as well as non-clinical student samples. Given the high cost of anxiety disorders to society, research is needed to examine the efficacy of self-administered treatments designed to reduce pathological worry. The primary goal of this study was to investigate the benefits of three self-administered interventions for reducing academic worry. College students (N = 113) experiencing clinically significant academic worry were randomized to either: (a) worry exposure (WE); (b) expressive writing (EW); (c) relaxation consisting of pulsed audio-photic stimulation (APS); or (d) waitlist control (WLC). Participants were instructed to practice their interventions three times per week for one month and completed home practice logs online to track treatment adherence. Academic worry, general anxiety, and perceived stress were assessed at baseline and post-treatment. Academic worry and general anxiety were also assessed at a three-month follow-up. Those assigned to the WE and APS conditions showed significant improvement relative to EW and WLC at post-treatment. All treatment conditions showed continued improvement by follow-up, with no between-group differences. Treatment and public health implications are discussed.     

Speaking, writing, and memory span in children: output modality affects cognitive performance

Low‐level processes of children's written language production are cognitively more costly than those involved in speaking. This has been shown by French authors who compared oral and written memory span performance. The observed difficulties of children's, but not of adults' low‐level processes in writing may stem from graphomotoric as well as from orthographic inadequacies. We report on five experiments designed to replicate and expand the original results. First, the French results were successfully replicated for German third‐graders, and for university students. Then, the developmental changes of the cognitive costs of writing were examined during primary school, comparing the performance of second‐ and fourth‐graders. Next, we show that unpractised writing modes, which were experimentally induced, also lead to a decrease of memory performance in adults, which supports the assumption that a lack of graphomotoric automation is responsible for the observed effects in children. However, unpractised handwriting yields clearer results than unpractised typing. Lastly, we try to separate the influences of graphomotoric as opposed to orthographic difficulties by having the words composed through pointing on a “spelling board”. This attempt, however, has not been successful, probably because the pointing to letters introduced other low‐level costs. In sum, throughout the four years of primary school, German children show worse memory span performance in writing compared to oral recall, with an overall increase in both modalities. Thus, writing had not fully caught up with speaking regarding the implied cognitive costs by the end of primary school. Therefore, conclusions relate to the question of how to assess properly any kind of knowledge and abilities through language production.     

Praying with the World at Heart

Praying with the world at heart is to learn to pray where people hurt, with those who suffer, with the poor. To pray is to shape the world, to expand ourselves, to hear God's voice and the voice of somebody else. In this article we want to learn how to do theology through prayer, thus, engaging the lex credendi through the lex orandi.     

Strategy instruction for writing composition at school and at home

Abstract

The objectives of this study are 1) to analyze the effectiveness of a writing composition intervention program aimed to increase children's writing performance and other personal variables; 2) to analyze whether implementation in the environment (school and home) or responsible figures (parents and teachers) produced different effects in program effectiveness; and 3) to check whether increasing parental involvement in doing homework was sufficient to improve children's outcomes or whether prior family training is required to enable them to be efficient. The sample consisted of 112 students (5th-6th grade) and their families. 26 of them made up the EFP group (mothers implementing a writing program), 25 of them were assigned to the PAD group (mothers increasing help with writing homework), 35 to the PRO group (teachers applying a writing program) and 26 to the OC group (ordinary curriculum). We analyze the results and present and discuss our conclusions.     

“Hidden Treasures” from Israeli Women's Writing Groups: Exploring an Integrative,Feminist Therapy

This article presents the work of mental health practitioners and laywomen who have developed and applied a new model of working with women in groups, a model founded on feminist principles that uses women's writing as the vehicle for group work. The model maintains a delicate balance between the needs of the group, the needs of the women in their social environment, and the women's ability to be the broker of their time, place, and mode of expression. This article presents the theoretical roots of the model and the qualitative evaluation of the writing groups that have been held over seven years, and it discusses how and why this model works for women of all ages and from all walks of life.     

How benefits of expressive writing vary as a function of writing instructions,ethnicity and ambivalence over emotional expression

Written emotional disclosure has been reported to confer a variety of benefits on physical and psychological well-being. However, variable findings suggest that outcomes may vary systematically as a function of specific parameters of the experimental design. This study aims to investigate the unique and combined effects of disclosure instructions focusing on emotional expression and instructions facilitating cognitive reappraisal and to examine how ambivalence over emotional expression and ethnicity moderate the effects of these writing instructions. Seventy-one Asian and 59 Caucasian undergraduates (N = 130) with at least minimal physical or depressive symptoms were randomly assigned to one of the four writing conditions: emotional disclosure (ED), cognitive reappraisal (COG), the combination of ED and COG, or a control condition. Self-reported physical symptoms, positive affect (PA) and negative affect were assessed at baseline and three follow-ups spanning 4 months. Mixed linear models revealed that COG writing reduced physical symptoms, ED buffered a decrease in PA over time, and the combination of ED and COG (i.e. self-regulation; SR) was most effective. Asians and highly ambivalent participants benefited most from expressive writing. Findings contribute to the development of a SR moderator model and carry implications for designing expressive disclosure studies, particularly for ethnic minorities.     

Pandora's box: An investigation of essay anxiety in adolescents

Abstract

This paper is an investigation into possible causes of essay anxiety experienced by adolescent students. The three students are presented as being representative of three broader categories: the non-starter, the non-completer and the non-exhibitor. Parallels are drawn between the student essay and student family relationships, and essay anxiety is explored in terms of the utilization of defences against the anxiety of loss. In the process, there is an attempt to appreciate some of the deeply rooted, inter-related, developmental factors - in particular, tolerance of aggressive impulses and the experience of the good object as modifying container - which might affect the student's ability to deal productively with an essay.